Aetna · Vermont · commercial in-network

Aetna negotiated rates in Vermont

How Aetna's Vermont rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.

Aetna in Vermont at a glance

Across 56 procedure codes for 8 specialties
Rate index vs state market
74
26% below the Vermont median
Rank in state
4 of 4
UHC 142 · Cigna 109 · BCBS 89 · Aetna 74
vs own national
94
Aetna's level vs its national median
Codes where highest
0%
of 56 codes
279 sampled providers162 TINs56 codesMedian 118% of Medicare · method

What the data shows

Generated from Vermont and Aetna data only
1

Aetna ranks 4th of 4 payers in Vermont with a rate index of 74 (100 = the Vermont market median), across 56 procedure codes.

2

Aetna has the highest median for only 0% of codes in Vermont; UnitedHealthcare leads with an index of 142 in the files analyzed.

3

Aetna's Vermont rates sit 6% below its own national level, the 35th highest of its 51 states.

4

Largest premium over the Vermont market: CPT 70551 (Mri brain stem w/o dye) at 100% of market; largest discount: CPT 45385 (Colonoscopy w/lesion removal) at 47%.

How the four payers compare in Vermont

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
UnitedHealthcare1421
142
79%279
Cigna1092
109
18%302
Blue Cross Blue Shield893
89
4%312
Aetna744
74
0%279

Where Aetna pays most and least against the Vermont market

Codes with the largest gap to the state median

Highest above market

CodeAetnaMarketGapProv.
70551
Mri brain stem w/o dye
$394$394+0%43
72141
Mri neck spine w/o dye
$394$394+0%43
73721
Mri jnt of lwr extre w/o dye
$394$400-2%51
73221
Mri joint upr extrem w/o dye
$394$401-2%51
72148
Mri lumbar spine w/o dye
$394$410-4%50
93970
Extremity study
$234$258-9%56
93971
Extremity study
$149$167-11%43
74177
Ct abd & pelvis w/contrast
$410$461-11%43

Furthest below market

CodeAetnaMarketGapProv.
45385
Colonoscopy w/lesion removal
$346$733-53%24
93000
Electrocardiogram complete
$18$30-42%117
71275
Ct angiography chest
$334$562-41%43
20610
Drain/inj joint/bursa w/o us
$56$92-39%123
99490
Chrnc care mgmt staff 1st 20
$41$64-36%16
93306
Tte w/doppler complete
$247$388-36%29
88305
Tissue exam by pathologist
$57$90-36%19
77080
Dxa bone density axial
$39$60-35%42

Where Aetna pays above and below its national level

Index vs the payer's own national median (100 = national)

Highest states

StateIndexProv.
Alaska306
211
Idaho152
491
Washington142
708
Mississippi138
608
Montana136
80

Lowest states

StateIndexProv.
Indiana80
698
South Dakota82
147
Florida82
758
Minnesota84
774
North Dakota85
211

Frequently asked questions

Does Aetna pay more or less than the other payers in Vermont?

Aetna ranks 4th of 4 in Vermont with an index of 74. It is highest on 0% of codes.

Are Aetna's Vermont rates above or below its national level?

About 6% below.

Which procedure does Aetna pay most above market in Vermont?

CPT 70551 (Mri brain stem w/o dye), at 100% of the Vermont median.

Methodology

How these numbers are calculated
  • Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
  • Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
  • Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
  • Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
  • Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
  • Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.

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